Cognitive-behavioral therapy for patients with post-COVID-19 condition (CBT-PCC): a feasibility trial, 2023, Huth et al.

Chandelier

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Cognitive-behavioral therapy for patients with post-COVID-19 condition (CBT-PCC): a feasibility trial

Huth, Daniel; Bräscher, Anne-Kathrin; Tholl, Sarah; Fiess, Johanna; Birke, Gunnar; Herrmann, Christoph; Jöbges, Michael; Mier, Daniela; Witthöft, Michael

Abstract
Background
The post-COVID-19 condition describes the persistence or onset of somatic symptoms (e.g. fatigue) after acute COVID-19.
Based on an existing cognitive-behavioral treatment protocol, we developed a specialized group intervention for individuals with post-COVID-19 condition.
The present study examines the feasibility, acceptance, and effectiveness of the program for inpatients in a neurological rehabilitation setting.

Methods The treatment program comprises eight sessions and includes psychoeducational and experience-based interventions on common psychophysiological mechanisms of persistent somatic symptoms.
A feasibility trial was conducted using a one-group design in a naturalistic setting. N = 64 inpatients with a history of mild COVID-19 that fulfilled WHO criteria for post-COVID-19 condition were enrolled.
After each session, evaluation forms were completed and psychometric questionnaires on somatic and psychopathological symptom burden were collected pre- and post-intervention.

Results The treatment program was well received by participants and therapists.
Each session was rated as comprehensible and overall satisfaction with the sessions was high.
Pre-post effect sizes (of standard rehabilitation incl. new treatment program; intention-to-treat) showed significantly reduced subjective fatigue ( p < 0.05, d av = 0.33) and improved disease coping ( ps < 0.05, d av = 0.33–0.49).

Conclusions Our results support the feasibility and acceptance of the newly developed cognitive-behavioral group intervention for individuals with post-COVID-19 condition.
Yet, findings have to be interpreted cautiously due to the lack of a control group and follow-up measurement, the small sample size, and a relatively high drop-out rate.

Web | DOI | Psychological Medicine | Open Access
 
Was made aware of this study by this tweet, machine translation:
Does anyone know the study by Dr. Sauer of Mainz University Medical Center?

cambridge.org/core/services/…

The study has significant methodological weaknesses: it does not differentiate between post-COVID, ME, and other conditions, yet it claims that CBT and the familiar biopsychosocial model can contribute to recovery.

I was forwarded a post by the organization Gemeinsam Genesen e.V., which indicates that they want to expand this concept by incorporating factors drawn from the experiences of the association’s members and their wider community, and make it accessible for health-insurance billing.

It’s a bit weird that the mentioned Dr. Sauer is not an author of this paper.
Anyway, it’s interesting to learn that there exists a German pro-CBT forum for ME/CFS:
 
It should be enough to quote back the limitations:
Several limitations have to be considered when interpreting our results. The lack of a control group, the small sample size, and the relatively high drop-out rate restrict the interpretation of the data. More precisely, the study design does not allow treatment effects to be attributed to the intervention since we pursued a one-group design and participants additionally received routine inpatient treatment.
In addition, health insurance coverage for inpatient rehabilitation did not cover the entire intervention duration in some cases, resulting in participants being discharged before study completion.
Moreover, results may have been biased due to the self-selection of participants, and because discontinuation of the study was associated with baseline clinical characteristics.
Lastly, information on the long-term effects of the intervention is missing.
 
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